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Circulation. 1998;98:731-733

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(Circulation. 1998;98:731-733.)
© 1998 American Heart Association, Inc.


Brief Rapid Communication

Prospective Study of C-Reactive Protein and the Risk of Future Cardiovascular Events Among Apparently Healthy Women

Paul M. Ridker, MD; Julie E. Buring, ScD; Jessie Shih, PhD; Mathew Matias, BS; ; Charles H. Hennekens, MD

From the Divisions of Cardiology (P.M.R.) and Preventive Medicine (P.M.R., J.E.B., C.H.H.), Brigham and Women's Hospital, and the Department of Ambulatory Care and Prevention (J.E.B., C.H.H.), Harvard Medical School, Boston, Mass; and Abbott Laboratories, Abbott Park, Ill (M.M., J.S.).

Correspondence to Paul M. Ridker, Cardiovascular Division, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115. E-mail pmridker{at}bics.bwh.harvard.edu

Abstract

Background—C-reactive protein (CRP) predicts risk of myocardial infarction (MI) and stroke among apparently healthy men, but in women, virtually no data are available.

Methods and Results—CRP was measured in baseline blood samples from 122 apparently healthy participants in the Women's Health Study who subsequently suffered a first cardiovascular event and from 244 age- and smoking-matched control subjects who remained free of cardiovascular disease during a 3-year follow-up period. Women who developed cardiovascular events had higher baseline CRP levels than control subjects (P=0.0001), such that those with the highest levels at baseline had a 5-fold increase in risk of any vascular event (RR=4.8; 95% CI, 2.3 to 10.1; P=0.0001) and a 7-fold increase in risk of MI or stroke (RR=7.3; 95% CI, 2.7 to 19.9; P=0.0001). Risk estimates were independent of other risk factors, and prediction models that included CRP provided a better method to predict risk than models that excluded CRP (all P values <0.01). In stratified analyses, CRP was a predictor among subgroups of women with low as well as high risk as defined by other cardiovascular risk factors.

Conclusions—In these prospective data among women, CRP is a strong independent risk factor for cardiovascular disease that adds to the predictive value of risk models based on usual factors alone.


Key Words: C-reactive protein • inflammation • cardiovascular diseases




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Diabetes CareHome page
D. E. King, A. G. Mainous III, B. M. Egan, R. F. Woolson, and M. E. Geesey
Fiber and C-Reactive Protein in Diabetes, Hypertension, and Obesity
Diabetes Care, June 1, 2005; 28(6): 1487 - 1489.
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Arterioscler. Thromb. Vasc. Bio.Home page
C. Arnaud, F. Burger, S. Steffens, N. R. Veillard, T. H. Nguyen, D. Trono, and F. Mach
Statins Reduce Interleukin-6-Induced C-Reactive Protein in Human Hepatocytes: New Evidence for Direct Antiinflammatory Effects of Statins
Arterioscler Thromb Vasc Biol, June 1, 2005; 25(6): 1231 - 1236.
[Abstract] [Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
A. W. Zieske, R. P. Tracy, C. A. McMahan, E. E. Herderick, S. Homma, G. T. Malcom, H. C. McGill Jr, J. P. Strong, and for the Pathobiological Determinants of Atheroscle
Elevated Serum C-Reactive Protein Levels and Advanced Atherosclerosis in Youth
Arterioscler Thromb Vasc Biol, June 1, 2005; 25(6): 1237 - 1243.
[Abstract] [Full Text] [PDF]


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StrokeHome page
M. Di Napoli, M. Schwaninger, R. Cappelli, E. Ceccarelli, G. Di Gianfilippo, C. Donati, H. C.A. Emsley, S. Forconi, S. J. Hopkins, L. Masotti, et al.
Evaluation of C-Reactive Protein Measurement for Assessing the Risk and Prognosis in Ischemic Stroke: A Statement for Health Care Professionals From the CRP Pooling Project Members
Stroke, June 1, 2005; 36(6): 1316 - 1329.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
B. Lo, R. Fijnheer, A. P. Nierich, P. Bruins, and C. J. Kalkman
C-Reactive Protein is a Risk Indicator for Atrial Fibrillation After Myocardial Revascularization
Ann. Thorac. Surg., May 1, 2005; 79(5): 1530 - 1535.
[Abstract] [Full Text] [PDF]


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Clin. Chem.Home page
A. Kovacs, P. Henriksson, A. Hamsten, H. Wallen, J. Bjorkegren, and P. Tornvall
Hormonal Regulation of Circulating C-Reactive Protein in Men
Clin. Chem., May 1, 2005; 51(5): 911 - 913.
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Diabetes CareHome page
Y. Doi, Y. Kiyohara, M. Kubo, Y. Tanizaki, K. Okubo, T. Ninomiya, M. Iwase, and M. Iida
Relationship Between C-Reactive Protein and Glucose Levels in Community-Dwelling Subjects Without Diabetes: The Hisayama Study
Diabetes Care, May 1, 2005; 28(5): 1211 - 1213.
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Cardiovasc ResHome page
S. B. Kritchevsky, M. Cesari, and M. Pahor
Inflammatory markers and cardiovascular health in older adults
Cardiovasc Res, May 1, 2005; 66(2): 265 - 275.
[Abstract] [Full Text] [PDF]


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Am. J. Physiol. Heart Circ. Physiol.Home page
Q. Wang, X. Zhu, Q. Xu, X. Ding, Y. E. Chen, and Q. Song
Effect of C-reactive protein on gene expression in vascular endothelial cells
Am J Physiol Heart Circ Physiol, April 1, 2005; 288(4): H1539 - H1545.
[Abstract] [Full Text] [PDF]


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Nephrol Dial TransplantHome page
E. M. Stuveling, S. J. L. Bakker, H. L. Hillege, P. E. de Jong, R. O. B. Gans, and D. de Zeeuw
Biochemical risk markers: a novel area for better prediction of renal risk?
Nephrol. Dial. Transplant., March 1, 2005; 20(3): 497 - 508.
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Diabetes CareHome page
S. Malik, N. D. Wong, S. Franklin, J. Pio, C. Fairchild, and R. Chen
Cardiovascular Disease in U.S. Patients With Metabolic Syndrome, Diabetes, and Elevated C-Reactive Protein
Diabetes Care, March 1, 2005; 28(3): 690 - 693.
[Abstract] [Full Text] [PDF]


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Alcohol AlcoholHome page
L. RETTERSTOL, K. E. BERGE, O. BRAATEN, L. EIKVAR, T. R. PEDERSEN, and L. SANDVIK
A DAILY GLASS OF RED WINE: DOES IT AFFECT MARKERS OF INFLAMMATION?
Alcohol Alcohol., March 1, 2005; 40(2): 102 - 105.
[Abstract] [Full Text] [PDF]


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J. Pharmacol. Exp. Ther.Home page
D. A. Lauver, E. A. Booth, A. J. White, E. Poradosu, and B. R. Lucchesi
Sulodexide Attenuates Myocardial Ischemia/Reperfusion Injury and the Deposition of C-Reactive Protein in Areas of Infarction without Affecting Hemostasis
J. Pharmacol. Exp. Ther., February 1, 2005; 312(2): 794 - 800.
[Abstract] [Full Text] [PDF]


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HypertensionHome page
I. J. Chang and R. C. Harris
Are All COX-2 Inhibitors Created Equal?
Hypertension, February 1, 2005; 45(2): 178 - 180.
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Arch Intern MedHome page
P. Bogaty, J. M. Brophy, L. Boyer, S. Simard, L. Joseph, F. Bertrand, and G. R. Dagenais
Fluctuating Inflammatory Markers in Patients With Stable Ischemic Heart Disease
Arch Intern Med, January 24, 2005; 165(2): 221 - 226.
[Abstract] [Full Text] [PDF]


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J. Appl. Physiol.Home page
C. K. Roberts and R. J. Barnard
Effects of exercise and diet on chronic disease
J Appl Physiol, January 1, 2005; 98(1): 3 - 30.
[Abstract] [Full Text] [PDF]


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CirculationHome page
S. C. Smith Jr, J. L. Anderson, R. O. Cannon III, Y. Y. Fadl, W. Koenig, P. Libby, S. E. Lipshultz, G. A. Mensah, P. M Ridker, and R. Rosenson
CDC/AHA Workshop on Markers of Inflammation and Cardiovascular Disease: Application to Clinical and Public Health Practice: Report From the Clinical Practice Discussion Group
Circulation, December 21, 2004; 110(25): e550 - e553.
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CirculationHome page
S. P. Fortmann, E. Ford, M. H. Criqui, A. R. Folsom, T. B. Harris, Y. Hong, T. A. Pearson, D. Siscovick, F. Vinicor, and P. F. Wilson
CDC/AHA Workshop on Markers of Inflammation and Cardiovascular Disease: Application to Clinical and Public Health Practice: Report From the Population Science Discussion Group
Circulation, December 21, 2004; 110(25): e554 - e559.
[Abstract] [Full Text] [PDF]


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Arch Intern MedHome page
L. M. Fischer, R. G. Schlienger, C. M. Matter, H. Jick, and C. R. Meier
Discontinuation of Nonsteroidal Anti-inflammatory Drug Therapy and Risk of Acute Myocardial Infarction
Arch Intern Med, December 13, 2004; 164(22): 2472 - 2476.
[Abstract] [Full Text] [PDF]


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J. Clin. Endocrinol. Metab.Home page
E. O. Talbott, J. V. Zborowski, M. Y. Boudreaux, K. P. McHugh-Pemu, K. Sutton-Tyrrell, and D. S. Guzick
The Relationship between C-Reactive Protein and Carotid Intima-Media Wall Thickness in Middle-Aged Women with Polycystic Ovary Syndrome
J. Clin. Endocrinol. Metab., December 1, 2004; 89(12): 6061 - 6067.
[Abstract] [Full Text] [PDF]


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HypertensionHome page
L. Niskanen, D. E. Laaksonen, K. Nyyssonen, K. Punnonen, V.-P. Valkonen, R. Fuentes, T.-P. Tuomainen, R. Salonen, and J. T. Salonen
Inflammation, Abdominal Obesity, and Smoking as Predictors of Hypertension
Hypertension, December 1, 2004; 44(6): 859 - 865.
[Abstract] [Full Text] [PDF]


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JAMAHome page
K. Yaffe, A. Kanaya, K. Lindquist, E. M. Simonsick, T. Harris, R. I. Shorr, F. A. Tylavsky, and A. B. Newman
The Metabolic Syndrome, Inflammation, and Risk of Cognitive Decline
JAMA, November 10, 2004; 292(18): 2237 - 2242.
[Abstract] [Full Text] [PDF]


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CROBMHome page
J. H. Meurman, M. Sanz, and S.-J. Janket
ORAL HEALTH, ATHEROSCLEROSIS, AND CARDIOVASCULAR DISEASE
Critical Reviews in Oral Biology & Medicine, November 1, 2004; 15(6): 403 - 413.
[Abstract] [Full Text] [PDF]


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CirculationHome page
T. Khreiss, L. Jozsef, L. A. Potempa, and J. G. Filep
Opposing Effects of C-Reactive Protein Isoforms on Shear-Induced Neutrophil-Platelet Adhesion and Neutrophil Aggregation in Whole Blood
Circulation, October 26, 2004; 110(17): 2713 - 2720.
[Abstract] [Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
J.-P. Despres
CRP and Risk of Coronary Heart Disease: Can Exercise Training Cool Down the Flames?
Arterioscler Thromb Vasc Biol, October 1, 2004; 24(10): 1743 - 1745.
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ThoraxHome page
S Kony, M Zureik, F Driss, C Neukirch, B Leynaert, and F Neukirch
Association of bronchial hyperresponsiveness and lung function with C-reactive protein (CRP): a population based study
Thorax, October 1, 2004; 59(10): 892 - 896.
[Abstract] [Full Text] [PDF]


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CirculationHome page
E. Zouridakis, P. Avanzas, R. Arroyo-Espliguero, S. Fredericks, and J. C. Kaski
Markers of Inflammation and Rapid Coronary Artery Disease Progression in Patients With Stable Angina Pectoris
Circulation, September 28, 2004; 110(13): 1747 - 1753.
[Abstract] [Full Text] [PDF]


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ANGIOLOGYHome page
J.-J. Li, C.-H. Fang, H. Jiang, C.-X. Hunag, Q.-Z. Tang, X.-H. Wang, and G.-S. Li
Increased C-Reactive Protein Level After Renal Stent Implantation in Patients with Atherosclerotic Renal Stenosis
Angiology, September 1, 2004; 55(5): 479 - 484.
[Abstract] [PDF]